Defining Active Labour

A quick snippet here, finally it is starting to become common practice to start counting active labour as 6cm dilated, instead of the 4cm previously used as the measure of success. Stepping aside a little from the debate over whether measuring a cervix is a helpful thing to do at all, this is a positive move for women and babies. As early labour can take a long time for many women, and it is prone to starting and stopping for quite a few, this could make a big difference to the numbers of women who are diagnosed with stalled labours at 5cm and who end up with their labours artificially accelerated or having caesarean surgery. This is particularly important for women panning a VBAC who may have had their primary caesarean for a stall at this point, or who got to the end and they or their babies were exhausted from an artificially hard labour.

Two senior doctors have written to the British Medical Journal to commend them for publishing a recent debate which highlights the way "in which the doctors supporting monitoring seem to cherry pick evidence" (Bewley and Braillon 2018). During this debate, Peter Brocklehurst, the "principal investig